Organization Active NPI

Lori Kanke, LCSW, LLC

  • Clinical Social Worker
  • Saint Joseph, MO
National Provider Identifier
1639611510
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2015004773 Issued in MO
Legal business name
LORI KANKE, LCSW, LLC
Practice address
2404 Highly St
Saint Joseph, MO 64506
Phone
(816) 351-9026
Fax
(816) 387-9307
NPI assigned
Nov 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lori Ann Kanke, LCSWNPI 1235412537
Title
Owner
Phone
(816) 351-9026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 2015004773 MO Primary

Addresses

Primary practice location

2404 Highly St
Saint Joseph, MO 64506

Mailing address

2404 Highly St
Saint Joseph, MO 64506-2729
Phone (816) 351-9026

Other identifiers 1

IdentifierTypeStateIssuer
1235412537MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161228001378 MO Part B Supplier - Clinic/Group Practice 8729369020 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Joseph, MO

National Provider Directory

National Provider Directory

Locations

2301 Frederick Ave
Ste 4
Saint Joseph, MO 64506
Phone (816) 351-9026

2404 Highly St
Saint Joseph, MO 64506
Phone (816) 351-9026

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1639611510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 HIGHLY ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062729",
            "telephone_number": "816-351-9026",
            "fax_number": "816-387-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 HIGHLY ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "64506",
            "telephone_number": "816-351-9026",
            "fax_number": "816-387-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI KANKE, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "KANKE",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-351-9026",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2015004773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235412537",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.